Image-guided periacetabular osteotomy: Computer-assisted navigation compared with the conventional technique - A randomized study of 36 patients followed for 2 years

Background: Periacetabular osteotomy (PAO) is an effective but technically demanding surgical procedure. We evaluated the efficiency of computer-assisted navigation in PAO and compared it with the traditional approach. Patients and methods: We performed a randomized study of 36 patients undergoing PAO using either the CT-based, computer-assisted navigation technique or the conventional approach. The operative details, radiographic results, and functional outcomes were compared between groups. Results: Patients in the conventional surgery group required an average of 4.4 (2-7) images of intraoperative radiographs, whereas only 0.6 (0-1) images were required in the navigation group. The operation time was 21 min shorter with computer-assisted navigation. No significant difference with regard to operative blood loss, transfusion requirement, correction of deformity, and functional improvement was found. Complications such as intraarticular damage, osteonecrosis, or neurovascular injury were not encountered. Interpretation: A computer-assisted navigation system is a feasible tool to provide real-time image guidance and facilitate PAO. However, it offers little additional benefit when the surgery is done by an experienced surgeon.